European Radiology

, Volume 24, Issue 1, pp 12–18 | Cite as

A new-generation, low-permeability flow diverting device for treatment of saccular aneurysms

  • Ajit S. Mallik
  • Katja Nuss
  • Peter W. Kronen
  • Karina Klein
  • Agnieszka Karol
  • Brigitte von Rechenberg
  • Daniel A. Rüfenacht
  • Isabel Wanke
  • Zsolt KulcsárEmail author



We report a preclinical comparative study of a 96-strand braided flow diverter.


The 96-strand braided device was compared with the currently commercially available flow diverter with 48 strands. The devices were implanted across the neck of 12 elastase-induced aneurysms in New Zealand White rabbits and followed for 1 and 3 months (n = 6 respectively). Aneurysm occlusion rates, parent artery stenosis and patency of jailed branch occlusions were assessed by angiography, histology and scanning electron microscopy studies.


It was feasible to navigate and implant the 96-strand device over the aneurysm orifice in all cases. At follow-up two aneurysms in the 48-strand vs. one in the 96-strand group were not occluded. This aneurysm from the 96-strand group however had a tracheal branch arising from the sac and showed a reverse remodelling of the vascular pouch at 3 months. In the occluded aneurysms, the parent artery was always completely reconstructed and the aneurysm orifice was sealed with neointimal tissue. No in-stent stenosis or jailed branch artery occlusion was observed.


The 96-strand flow diverter proved to be safe, biocompatible and haemodynamically effective, induced stable occlusion of aneurysms and led to reverse remodelling of the parent artery.

Key points

• Flow diversion has been introduced to improve endovascular treatment of cerebral aneurysms

• A new low-permeability flow diverter is feasible for parent artery reconstruction.

• The Silk 96 flow diverter appears effective at inducing aneurysm healing.

• The covered branches remained patent at follow-up.


Flow diverter Aneurysm Stenting Thrombus Porosity Pore density 



Common carotid artery


Digital subtracted angiography


Flow diverter


Parent artery


Scanning electron microscopy


Vertebral artery



Zsolt Kulcsár and Isabel Wanke are proctors for Silk implantation.This work was partially supported by a grant from the Swiss National Science Foundation (SNSF) (CR32I3-127008). The work was partially funded by Balt International. Balt International had no editorial authority in the drafting or editing of this article.


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Ajit S. Mallik
    • 1
  • Katja Nuss
    • 2
  • Peter W. Kronen
    • 1
    • 2
    • 3
  • Karina Klein
    • 2
  • Agnieszka Karol
    • 2
  • Brigitte von Rechenberg
    • 1
    • 2
  • Daniel A. Rüfenacht
    • 1
    • 4
  • Isabel Wanke
    • 1
    • 4
    • 5
  • Zsolt Kulcsár
    • 1
    • 4
    Email author
  1. 1.Center of Applied Biotechnology and Molecular MedicineUniversity of ZurichZurichSwitzerland
  2. 2.Musculoskeletal Research UnitEquine Hospital, Vetsuisse Faculty, University of ZurichZurichSwitzerland
  3. 3.Veterinary Anaesthesia Services-InternationalWinterthurSwitzerland
  4. 4.Department of NeuroradiolgySwiss Neuro Institute, Hirslanden ClinicZurichSwitzerland
  5. 5.Institute of Diagnostic and Interventional Radiology and NeuroradiologyUniversity Hospital of EssenEssenGermany

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